Everything you need to know about health insurance and cosmetic surgery

It’s easy for people to assume that cosmetic surgery just involves nose jobs and breast enhancements, but what most people don’t know is that it’s not unusual for cosmetic surgery to be deemed completely medically necessary by medical professionals. And luckily for the people in this boat, private health insurance can help fund your surgery. Here’s how to go about it:

Learn the terminology

The difference between a medically necessary procedure and an elective procedure comes down to professional opinion. The purpose of reconstructive plastic surgery is typically to correct abnormalities, which can come in a multitude of forms and be caused by a range of things. For example, an abnormality could be either congenital or acquired. However, as a general rule, if a doctor or specialist formally recommends surgery as an option for treatment, there is a very high chance that your insurance provider will recognise this and provide a rebate for it.

Know your cover

If you do have private health insurance, what you really need to know is what kind of procedures you’re covered for. There are a few procedures that a comprehensive hospital policy should typically cover. In terms of recovery and recuperation, not a lot of treatments are covered, but it can include (not limited to):

  • Surgeries to fix congenital abnormalities (conditions that you have been born with or that have existed before birth).
  • Reconstructive surgery as treatment for extreme burns.
  • Surgery to fix a traumatic injury.
  • Cancer or tumour removal, or surgeries that follow the removal of a cancer or tumour (for example, a reconstruction after a mastectomy).
  • Procedures to repair bad scars or skin lacerations.

Know your options

There are three main private health insurance options for plastic and reconstructive surgery. You can:

  • Take out a comprehensive policy that covers you for reconstructive plastic surgery.
  • Choose a policy that offers restrictive cover for reconstructive plastic surgery in order to lower your premiums.
  • Choose a policy that excludes cover for reconstructive plastic surgery altogether.

Make the most of what you’re paying for

Excluding or restricting plastic surgery from your policy is something that a lot of people do, but although it may cut costs in the short-term, you’ll never know whether you’ll need it later on down the track. It’s also important to review your health insurance policy regularly– every year if you can. It doesn’t take long, just go over your current cover and work out whether you think you need to add or remove any elements. For example, if you’re a senior paying for cover for pregnancy-related services, your money could definitely be put towards something more useful.

If you’re looking into taking out a higher level of cover, compare health insurance policies for cosmetic surgery online to make sure you’re getting the best value for money. What you choose is completely up to you. If you need more information later down the track, have a look at the Ombudsman’s website.

Bessie Hassan is finder.com.au’s resident Insurance Expert.

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